What the hospital's own published prices say about an $18,647 asserted balance
Hospital charges asserted against a personal-injury recovery — an unpaid balance, a reimbursement demand, or, where state law provides one, a lien — are typically stated at gross charges, the hospital's list price. Federal law (45 CFR 180.50) requires every hospital to also publish what it actually accepts: its cash price and its negotiated rates with each named insurer. That disclosure, published by the hospital itself, provides the reference points for evaluating whether an asserted amount reflects what the hospital routinely accepts for the same services.
Exhibit A — The asserted charges against the hospital's own benchmarks
| Service (CPT) | Billed (gross) | Hospital's cash price | Commercial median¹ |
|---|---|---|---|
| ER visit, Level 4 (99284) | $4,337 | $4,337 | $2,912.53 |
| CT head, no contrast (70450) | $4,660 | $4,660 | $1,025.20 |
| CT chest, no contrast (71250) | $8,531 | $8,531 | $1,791.51 |
| Chest X-ray, 2 views (71046) | $1,119 | $1,119 | $232.75 |
| Total | $18,647 | $18,647 | $5,961.99 |
¹ Median of the hospital's published negotiated rates across 25–30 commercial-plan entries per code (named insurers and networks; excludes Medicare Advantage, Medicaid, Tricare, dual-eligible, and exchange rates — an exclusion that favors the hospital, since including government-plan rates would lower the median). CJW is an HCA hospital: its disclosed self-pay (cash) price equals its full gross charge on every line above.
Exhibit B — Named-payer detail for the largest line item
| Reference point | Amount |
|---|---|
| Lowest published commercial rate (UnitedHealthcare) | $245.18 |
| Commercial median (27 plan entries) | $1,791.51 |
| Highest published commercial rate (Multiplan · PHCS) | $7,677.90 |
| Hospital's posted cash price (equal to gross) | $8,531 |
| Billed in this matter (gross) | $8,531 |
The billed amount sits above every commercial rate the hospital has published for this service — including its highest — and the posted cash price offers no relief, since it equals the gross charge. The full commissioned brief includes this exhibit for every code on the itemized bill, with each insurer and plan named.
What a commissioned brief includes
This sample covers four illustrative facility line items. A real encounter's itemized bill carries more codes (labs, medications, supplies), and professional fees (physician, radiology reads) are billed separately by different entities. The commissioned brief works from the actual itemized statement and covers:
- Every facility line item benchmarked against the hospital's gross, cash, and named-payer negotiated rates;
- A chain-of-custody appendix: the exact machine-readable file analyzed, its version and retrieval date, its checksum, and the CMS-defined field each number came from — so every figure survives a hostile fact-check;
- All numbers re-derived from the source disclosure on the day of delivery;
- A methodology statement written to be attached, quoted, or exhibited as-is.
What this is — and what it is not
This brief is a data analysis of the hospital's own public disclosures, with documented methodology. It reports what the hospital publishes; it does not assert what the hospital must accept, does not provide legal advice or expert testimony, and makes no claim about any individual insurance plan's actual terms. HospitalCost is independent — no compensation from any hospital or insurer, ever. Engagements are commissioned by counsel or plan sponsors; patients are never charged.